Gardens for people with dementia

Ah, gardens! Fabulous places. Outdoor spaces are an important part of human life. They offer opportunities for relaxation, connection with nature, the chance to nurture and care for living things and the sensory benefits of sunlight, fresh air, soil and water. Today’s post offers resources on garden design for people with dementia, the benefits of gardens for aged care facilities and how to successfully implement both outdoor and indoor gardens.

Dig in!

Book: Creating Culturally Appropriate Outside Spaces and Experiences for People with Dementia: Using Nature and the Outdoors in Person-Centred Care edited by Mary Marshall and Jane Gillard

Demonstrating that it is essential to be sensitive to the cultural backgrounds of people with dementia in order to provide truly person-centred care, this book shows that it is possible to create culturally appropriate outdoor spaces and experiences that resonate with people with dementia on a fundamental level and are a source of comfort and well-being.

Contributors drawn from a variety of backgrounds describe the significance of nature in the lives of people with dementia from diverse cultures, faiths, traditions and geographical locations, providing helpful insights into how access to the natural world may be achieved within different care settings. There are contributions from the UK (Scottish island, urban North East England and Norfolk farming communities), Canada, Norway, Japan, Australia, Sudan and South Africa, as well as a chapter on the specific difficulty of providing access to nature for people with dementia in hospitals. The voices of people with dementia and their carers are prominent throughout, and the book also contains evocative poetry and photographs of people with dementia enjoying nature and the outdoors in different contexts.

A rich source of information and ideas for all those interested in creating culturally appropriate outdoor spaces and experiences for people with dementia, including dementia care practitioners, especially those at managerial level, policy makers, commissioners and those involved in designing and commissioning buildings and services.

The current study examined the effect of an indoor simulated garden installation that included visual, auditory, and olfactory stimuli on resident well-being, compared to the effect elicited by a reminiscence installation and a control no-installation condition. A quasi-experimental ABA design was used (i.e., two intervention conditions plus a wait-list control condition). A survey instrument was administered to nursing home residents (N = 33) at three time points (pre-, during, and post intervention) over an 8-week period, which measured mood, behavior, health, and social interaction. Additionally, staff reports (N = 24) were collected. Both the nature-based and non-nature-based installations led to enhanced well-being and significantly more social benefits for residents because of their novel and aesthetic appeal, compared with the control condition. Residents in the nature-based installation condition reported more satisfaction with their living environment during the intervention phase than those in the comparison conditions. The results show that an indoor garden simulation is a relatively inexpensive way to transform a disused indoor area of an aged-care facility for the benefit of residents and staff.

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Book: Designing outdoor spaces for people with dementia edited by Annie Pollock and Mary Marshall

In many facilities for people with dementia, there is often little or no access to the outdoors and to fresh air. Research shows that there are considerable benefits that come from spending time outdoors and having a good view out from a building. So, why is it that people living with dementia, often have poor access to outside spaces and the benefits that come from being outside?

‘Designing Outdoor Spaces for People with Dementia’ is a book that discusses how to effectively use outside spaces for people with dementia. The book is not an academic guide to research but a book for people in practice. It is filled with case studies of real examples from all over the world. The book is edited by internationally respected Mary Marshall and Annie Pollock.

Featuring authors from Japan, USA, Australia and Norway as well as the UK, the book provides a review of evidence based research supporting the importance of access to outdoor spaces; understanding how to use outdoor spaces appropriately and case studies from around the world describing how to develop and utilise well designed spaces for people with dementia.

The book is written for people who own and commission buildings for people with dementia, Architects and Landscape Architects, Managers of facilities for people with dementia, Medical, nursing and care staff as well as professions allied to medicine such as occupational therapists and physiotherapists and relatives of people with dementia and people living with dementia.

Article: Designing a garden for people with dementia – in a public space by Sally Furness and Jo Moriarty, Dementia, Vol. 5, no. 1 February 2006 p. 139-143

Charlecote Park is a Tudor house in Warwickshire, UK where Shakespeare is rumoured to have been once caught poaching. It is set in a deer park that was originally designed by Capability Brown, the famous British 18thcentury landscape gardener who was responsible for redesigning many of the gardens owned by the aristocracy of the time. Both house and garden are now owned by the UK’s National Trust and they are open to the public for the majority of the year. In 2002, the South Warwickshire branch of the Alzheimer’s Society commissioned Sally Furness to manage the creation of a therapeutic garden within a designated plot at Charlecote Park. The choice of site was important. Not only is the park an attractive place that is popular with visitors during the summer but, by integrating a garden for people with dementia into a public space, it was intended to help improve public awareness of the condition.

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Article: The Grange Garden Project : A garden for people with dementia – in a day centre by Maggie Weatherby and Jo Moriarty, Dementia, Vol. 5, no. 1 February 2006 p. 143-146

The Grange is a day centre for people with dementia located in north London and run by Haringey council. Although there was a garden at the rear of the building, it consisted of little more than a lawn, two or three mature trees, some overgrown shrubs and a summerhouse. Unsurprisingly, given the unstimulating environment, it was rarely used. This changed in 2002 when Olive Harper, one of the committee members of the Haringey Branch of the Alzheimer’s Society decided to apply for an After Dementia Millennium Award organized by the Alzheimer’s Society. These awards were funded by the Millennium Commission and consisted of grants for carers and former carers of a person with dementia to help them rebuild their lives and make links with their community during and after their caring role. She decided that she would apply for a grant to help set up a Grange Garden Carers Group. The group members wanted to develop the garden as a way of ‘giving something back’ in return for the support that they had received from the centre and to improve the quality of the environment for people with dementia, carers, and staff by providing somewhere in which people could relax, undertake simple horticultural tasks and keep in touch with nature through sensory stimulation.

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Article: Parkview House : A garden for people with dementia – in a care home by Simon Pollitt and Jo Moriarty, Dementia, Vol. 5, no. 1 February 2006 p. 146-149

Parkview House opened in 1993 as a care home for people with dementia in north London. It is owned by Sanctuary Housing Association and managed by 2Care, an independent charity supporting older people and people with mental health needs. The building itself is a modern two-storey design and is located in a residential area next to a park. Forty-five people live in the home and the intention is that they should be offered a home for life wherever possible.

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Book: Designing balconies, roof terraces and roof gardens for people with dementia by Mary Marshall, Emeritus Professor, University of Stirling

This book is one of a series to assist providers, architects, commissioners and managers to improve the design of buildings which are used by people with dementia. The book has been produced in response to an increasing number of requests for advice about the provision of outside space for buildings of more than one storey. As land values increase and people wish to remain in familiar inner city areas, we are more likely to see higher multi-storey care homes. This book describes practical ways in which new and existing buildings can maximise opportunities for people with dementia to access outside space using balconies, roof terraces and roof gardens.

Unique and comprehensive, Healing Gardens provides up-to-date coverage of research findings, relevant design principles and approaches, and best practice examples of how for more and more people, the shortest road to recovery is the one that leads through a healing garden. Combining up-to-date information on the therapeutic benefits of healing gardens with practical design guidance from leading experts in the field, Healing Gardens is an invaluable guide for landscape architects and others involved in creating and maintaining medical facilities as well as an extremely useful reference for those responsible for patient care. With the help of site plans, photographs, and more, the editors present design guidelines and case studies for outdoor spaces in a range of medical settings, including: acute care general hospitals; psychiatric hospitals; children’s hospitals; nursing homes; Alzheimer’s facilities; hospices.

In this first of two articles, Garuth Chalfont discusses the benefits to people with dementia of everyday contact with gardens and the natural world, and gives guidance on how care homes can make engaging with nature a normal, regular aspect of daily life.

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In the second of two articles, Garuth Chalfont gives practical advice on creating a Dementia Care Garden, and presents a case study showing how one care home improved and integrated three garden areas.

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